I didn't think that those letters seemed unreasonable.
Really? From what perspective do you find it reasonable?
I think it superficially seems reasonable, which is probably why they've had so much success promoting such a paradigm. I think it would especially seem reasonable to anyone ignorant of all the issues, including ignorance of science in general, the scientific process, and all the issues specifically relating to ME and CFS.
But in terms of science and medicine, it's corrupt. They are ignoring, and dismissive of, the specific symptoms, and the nature of onset, associated with the incline village outbreak, and associated with ME; apart from the single symptom of fatigue, which they inappropriately place their entire emphasis on. And they are also dismissive (but without sufficient evidence to inform them) of the
possibility that there maybe a discrete illness, or group of illnesses, that have the symptoms described by ME criteria.
And they're not even discussing the difference between idiopathic fatigue and ME. They've already dismissed ME criteria by this stage and are now discussing the lack of difference between idiopathic fatigue and CFS. There isn't much difference between idiopathic fatigue and CFS because that's how they, themselves, designed the CFS criteria. So, again, the discussion seems superficially reasonable, as they are discussing 'CFS' and not 'ME'.
They propose that chronic fatigue should be diagnosed as either idiopathic fatigue or secondary to an identifiable medical or psychiatric disorder, with no other possibilities, and predict that the notion of a discrete form of fatiguing illness will eventually evaporate. This seems obvious and reasonable, in itself: Fatigue is universal, and if you can't identify the source of pathological 'fatigue' and associate it with a discrete illness then it is, by definition, idiopathic fatigue. But they are ignoring the nature of ME for which fatigue is only a single symptom, and for which fatigue has a discrete nature.
They also seem to be undermining the scientific process by curtailing any scientific curiosity that there may be in attempting to identify different types of fatigue and different sources of fatigue. Instead of dismissing possibilities they should be encouraging biomedical investigations into differences, however subtle.
(Luckily, that sort of prehistoric approach to medicine is
beginning to be relegated to history now: even psychiatric research in the USA is moving away from symptom based research and towards investigating biomedical pathways.)
It seems that they were keen to push fatigue research into the field of psychiatry, with their discussion re fatigue being confined to a single locus of the brain. Perhaps that, in itself, was a reasonable hypothesis, but it was only a hypothesis and the hypothesis only related to fatigue, and not to other symptoms experienced in ME. As such, their partial hypothesis should not have been rolled out as a government department strategy for ME patients or incline village patients.
I don't see how this correspondence can be considered reasonable when considering the full history of ME and CFS. But even taking it purely at face value I think it demonstrates a massive failure of the scientific process within a government department. Given what we know, it probably came about as a result of vested interests and corrupt practices.